Correspondence of Barrier Membrane Exposure after Guided Tissue Regeneration Procedure

A Case Report

Abstract

The guided tissue regeneration (GTR) procedure has been reported to result frequently in membrane exposure by sloughing. Barrier membrane expo-sure increases the incidence of infection and decreases the amount of regenerated tissue. It is difficult to cover the regenerated tissue after mem-brane removal in the GTR procedure because of the large amount of sloughing. We use a subepithelial connective tissue graft after membrane removal to protect the regenerated tissue. A 42-year-old woman presented with gingival swelling, which was diagnosed as moderate adult periodontitis. Follow-ing initial therapy, the GTR procedure using a non-resorbable membrane (Gore Tex Periodontal material) was performed for a maxillary first premolar with an intrabony defect. Barrier mem-brane exposure due to sloughing of the flap was evident at 1 week. We removed the membrane at 5 weeks because increasing of slouging and mem-brane exposure. There was rubbery hard regener-ated tissue under the barrier membrane. However it is impossible to cover regenerated tissue with a flap. We used a subepithelial connective tissue graft to cover the regenerated tissue. A good shape of the gingiva could be obtained by means of graft. This report suggests that a subepithelial connective tissue graft for membrane exposure in the GTR procedure is one of the useful clinical options that protect the regenerated tissue and achieves an esthetically pleasing result.